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Active, Not Recruiting

NCT Number: NCT05553834

PCSK9 Inhibitor and PD-1 Inhibitor in Patients With Metastatic, Refractory To Prior Anti PD-1 Non-small Cell Lung

PCSK9 mediates immune checkpoint blockade resistance by downregulating tumor cell surface MHC class 1 molecules. This study will evaluate if combining the anti-PCSK9 antibody alirocumab with the anti-PD-1 antibody cemiplimab can generate anti-tumor activity and clinical responses in patients with metastatic lung cancer who have progressed on first line immune checkpoint blockade therapy.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Moffitt Cancer Center, Tampa, Florida, United States

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Histologically documented recurrent and/or metastatic non-small cell lung cancer
  • Progression after prior PD-1 directed therapy (as monotherapy or in combination with chemotherapy and/or anti-CTLA4, or anti-VEGF agents) - defined as investigator assessed progression from prior treatment
  • If molecularly altered NSCLC including EGFR, ALK, ROS1, MET exon 14, RET, BRAF, NTRK, progression on prior targeted therapy is required
  • Measurable disease by RECIST 1.1
  • ECOG Performance Status 0 or 1
  • Signed written informed consent
  • Minimum of 4 weeks from any other experimental anti-cancer therapies or prior PD-1 treatment
  • Meet all the laboratory criteria per protocol

Exclusion criteria

  • Prior treatment with PCSK9 inhibitors
  • Cardiac issues including MI, uncontrolled arrhythmia, symptomatic angina pectoris, active ischemia, or cardiac failure not controlled by medications.
  • Uncontrolled diabetes mellitus, defined as HbA1c > 10
  • Major surgery less than 4 weeks prior to study enrollment
  • Another malignant condition diagnosed within 3 years of study enrollment
  • Intolerance to prior PD-1/L1 treatment including discontinuation for severe or recurrent severe toxicity (including myocarditis or other myocardiotoxity, encephalitis, colitis, diarrhea, pancreatitis, hypo/hyperthyroidism, hypopituitarism, adrenal insufficiency, rash, autonomic neuropathy, myasthenia gravis, Guillain-Barre, myositis/polymyositis, hepatitis, Type 1 Diabetes, thrombocytopenia) or developed an immune checkpoint blockade related immune adverse event that was refractory to steroids and required additional systemic immunosuppressive medication.
  • Known history of HIV seropositivity or known acquired immunodeficiency syndrome (AIDS)
  • Additional exclusion criterion as per listed in the protocol

Treatment and study plan

Alirocumab and Cemiplimab

Combination Product

Combination of PCSK9 inhibitor Alirocumab 150mg SC q2weeks and PD-I inhibitor Cemiplimab 350mg IV q3 weeks

Primary outcomes

  1. Response rate associated with combination of alirocumab and cemiplimab

    Time frame: Day 1 of treatment until the date of first documented progression or date of death, whichever comes first, assessed up to 110 weeks per RECIST 1.1

    Ascertain the response rate associated with alirocumab and cemiplimab, with 95% confidence intervals. Response rate is defined as the proportion of treated subjects with a complete or partial response per RECIST 1.1 criteria. All patients who receive at least one dose of alirocumab and cemiplimab will be considered for the primary outcome analysis

Secondary outcomes

  1. Safety and tolerability of the combination regimen

    Time frame: Day 1 of treatment until 30 days post last dose

    Toxicity analysis will be performed on a continual basis following CTC V 5.0 criteria

  2. Progression Free Survival

    Time frame: Day 1 of treatment until the date of first documented progression or date of death, whichever comes first, assessed up to 110 weeks

    Progression Free Survival will be assessed utilizing RECIST 1.1 criteria

  3. Overall survival

    Time frame: Day 1 of treatment until death or off study due to any other reason whichever comes first, assessed up to 110 weeks

    Patients will be followed till death or off study due to any other reason

Sponsors and collaborators

Lead sponsor

Duke University

Other

Collaborators

  • Regeneron Pharmaceuticals

Registry information

Official study title

A Phase II Study of PCSK9 Inhibitor Alirocumab and PD-1 Inhibitor Cemiplimab in Patients With Metastatic, Refractory To Prior Anti PD-1 Non-small Cell Lung Cancer: TOP2201

Important dates

Study start
2023
Primary completion
2025
Study completion
2026
First posted
Sep 23, 2022
Registry last updated
Apr 13, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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